Supervisor, Risk Adjustment Coding

Prominence-Health-Plan; Reno (NV); On-site; USD 85,000 - 110,000; Full time

Job summary

Prominence Health is seeking a Risk Adjustment Coding Supervisor to oversee the coding team, ensure CMS/HCC coding accuracy, and maintain coding policies across internal programs. The role includes training, staff development, and contributing to RADV audits as well as vendor relationships.

The ideal candidate has 3-5 years of CMS HCC risk adjustment coding experience, proficiency in ICD-10, and strong communication skills.

Qualifications

• High school education or GED required; Associate’s degree preferred.
• Coding certification (CCS or CPC) and ICD-10 proficiency.
• 3-5 years CMS HCC risk adjustment coding experience.
• 2+ years in a managed care setting.
• RHIT and CRC certification preferred.
• Ability to effectively communicate in English, both verbally and in writing.
• Proficient in Microsoft Office Suite: Word, Excel and Access.
• Excellent written and oral communication skills.
• Attention to detail.
• Billing experience is a plus.
• Experience with NCQA HEDIS programs preferred; healthcare setting experience noted.

Responsibilities

• Oversee and audit the coding team for accuracy and productivity.
• Develop, update, and maintain Prominence’s coding policy per CMS guidelines.
• Support production coding by assigning queues and projects.
• Identify underperforming coders and implement targeted training plans.
• Collaborate with the Prominence educator to conduct training for providers.
• Evaluate staffing needs and assist with hiring and onboarding.
• Assist RADV audits and manage vendor relationships to improve processes.

Skills

Attention to detail

Communication skills

Microsoft Office

Education

High school diploma or GED

Associate’s degree

Tools

Microsoft Word

Excel

Access

Job description

Responsibilities

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.

Learn more at: https://prominence-health.com/

Job Summary:

the Risk Adjustment Coding Supervisor will be responsible for overseeing and auditing the coding team for accurate coding and reviews to ensure productivity and accuracy is maintained within all internal coding programs. The Supervisor will take an active role in developing, updating, and maintaining Prominence’s coding policy therefore must demonstrate experience and knowledge in CMS Coding and Documentation Guidelines as well HCC coding policies. The Coding Supervisor will support production coding as needed, assign and task work queues and projects to staff. The Supervisor will identify coders on the team that are not maintaining accuracy to conduct further training and set improvement plans. They will also identify opportunities for coding and documentation education for providers and work with the Prominence educator to successfully carry out trainings and education. The Supervisor will also be responsible for evaluating and assessing the department’s staffing needs, hiring, and conducting training/orientation. The Supervisor will report to the department Manager as well as assist with RADV audits, vendor relationships, and play a key role in decision making for the department to improve processes and establish better efficiencies.

Benefit Highlights:

• Loan Forgiveness Program
• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services:

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

Qualifications

Qualifications and Requirements:

• High school education or GED required. Associate's degree preferred.

• Coding certification (CCS or CPC through AHIMA/AAPC) ICD-10 coding proficiency

• 3-5 years’ experience in CMS HCC risk adjustment coding

• 2+ years’ experience in a managed care setting

• RHIT and CRC certification preferred.

• Ability to effectively communicate in English, both verbally and in writing.

• Proficient in Microsoft Office Suite, Word, Excel and Access

• Excellent written and oral communication skills

• Attention to the detail.

• Billing experience is a plus.

• Comfortable working in a department with set productivity and coding accuracy standards Experience with NCQA HEDIS programs preferred. Experience working in health care and health

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.